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Indiana rates for HCPCS 15733

Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$854.07 / $3,429.14 / $14,931.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$854.07 / $932.07 / $1,259.66
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,614.00 / $9,200.00 / $18,942.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$837.04 / $984.76 / $1,326.66
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$828.95 / $1,207.44 / $1,300.32
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$928.80 / $1,114.56 / $1,325.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,623.15 / $2,623.15 / $2,623.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$920.11 / $1,224.79 / $1,646.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,932.00 / $8,025.00 / $11,038.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$810.39 / $1,122.72 / $1,728.97